The relationship between mean platelet volume (MPV) and coronary artery disease, atherosclerotic vascular pathologies, and platelet aggregation is not well established. [1],[2] Platelet activation in patients with chronic kidney disease (CKD) may contribute to cardiovascular mortality. [3] Inflammatory markers such as C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), ferritin, and interleukin IL-10 and IL-6 are also indicators for cardiovascular disease in patients with CKD. We did a study to investigate the relationship between MPV and inflammatory markers, blood pressure and comorbidities in patients undergoing renal replacement therapy.

The demographic and clinic features of all patients are summarized in [Table 1]. Statistically significant correlations were found between MPV and office blood pressure; daytime systolic blood pressure (SBP) and daytime diastolic blood pressure (DBP) in HD and PD patients; however, MPV correlated only with nighttime SBP and nighttime DBP in KTrs. The mean values of IL-6, IL-10, ESR, ferritin, and MPV were found significantly higher in the presence of comorbid conditions.

Hypertension is an important risk factor for heart attack, stroke and other vascular diseases. [4],[5] Nadar et al [6] reported that MPV in hypertensive patients was higher than that of the normotensive subjects. MPV was found elevated in gestational hypertensive patients according to normotensive pregnant. [7] In our study, we found a significant correlation between MPV and blood pressure in all three patient groups receiving renal replacement therapy. Kaya et al [8] found more increased CRP and higher MPV in non-dipper patients rather than dipper group.

Moreover, MPV significantly correlated with CRP levels. Guven et al [9] reported that elevated MPV values positively correlated with higher CRP in masked hypertensive patients. On the other hand, in our study, there was no correlation between CRP and blood pressure in patient groups treated with renal replacement therapy groups.

Vascular complications are known as a result of endothelial damage and thrombosis. [10] In various studies, elevated thrombocyte volume was specified as an independent risk factor for cardiovascular diseases in diabetic and hyper-lipidemic patients. [11] MPV was significantly higher in our patients with comorbid situations such as hypertension and diabetes mellitus compared with those without comorbid conditions.

Thrombocyte abnormalities in dialysis patients are due to activation and consumption of thrombocytes during their contact with dialysis membranes, and only small thrombocytes survive in circulation. [12],[13] In our study, PD patients had lower MPV but nonsignificantly. Ju et al [14] found that glomerular filtration rate negatively correlated with MPV.

In conclusion, MPV was not elevated in patients with CKD and healthy control groups, but MPV, ESR and ferritin were significantly higher in patients undergoing renal replacement therapy with co-morbid conditions including DM, hypertension, and CAD compared with those without comorbid conditions. IL-6, IL-10, CRP and MPV levels were not significantly different in HD patients, PD patients, KTrs, and healthy controls. MPV positively correlated with blood pressure in all RRT groups and healthy controls. We cannot say that MPV as a noninvasive test can be beneficial for the assessment of cardiovascular risk in CKD.